$570.23
67208 treats a localized retinal lesion with cryotherapy. This code treats a localized choroidal lesion with photocoagulation.
On this page
CMS RVU26D · Effective 2026-10-01
67220 Choroidal lesion treatment Medicare reimbursement rates in Indiana
Laser photocoagulation to destroy a localized choroidal lesion is reported when the treated target is in the choroid, not the retina. Compare 67220 office and facility rates across CMS payment localities in Indiana.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 67220 in Indiana?
Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$501.28
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
Facility setting
$404.68
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Ophthalmology
About 67220: Choroidal lesion laser photocoagulation
Laser photocoagulation to destroy a localized choroidal lesion is reported when the treated target is in the choroid, not the retina.
An ophthalmologist, often a retina or ocular oncology specialist, uses laser photocoagulation to destroy a localized lesion in the choroid. The code can cover one or more treatment sessions for that lesion. The key distinction is the treated tissue: a choroidal target supports this code, while a retinal target points to a retinal-lesion code. Treatment is commonly performed in an ophthalmology office or an outpatient facility.
Report the service based on the lesion’s choroidal location and the laser treatment documented. The record should identify the treated eye and lesion and describe the photocoagulation performed. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 67220
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.20 · 39%
- Practice expense (office) RVU9.25 · 58%
- Malpractice RVU0.48 · 3%
1.4K
Medicare services in 2024 · #2722 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
67220 compared with similar codes
Office rates for Indiana, from the same CMS release.
$487.51
67210 is photocoagulation for a retinal lesion. Choose this code when the documented treatment target is choroidal.
No office rate
67218 uses a radioactive plaque for a localized choroidal lesion; this code describes photocoagulation of the lesion.
67221
No office rateOcular photodynamic ther
67221 describes photodynamic therapy for a choroidal lesion. This code is selected for photocoagulation instead.
Compare 67220 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Indiana →
Office / nonfacility
$501.28
Facility
$404.68
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 67220 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
7,444
- Code
- 67220
- Physician work
- 6.20
- Practice expense
- 9.25
- Malpractice
- 0.48
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.20 | × 1.000 | 6.2000 |
| Practice expense | 9.25 | × 0.927 | 8.5747 |
| Malpractice | 0.48 | × 0.486 | 0.2333 |
| Total RVUs | 15.0080 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$501.28
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.2 | 1 |
| Practice expense | 9.25 | 0.927 |
| Malpractice | 0.48 | 0.486 |
(6.2 × 1 + 9.25 × 0.927 + 0.48 × 0.486) × $33.4009 = $501.28
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.2 | 1 |
| Practice expense | 6.13 | 0.927 |
| Malpractice | 0.48 | 0.486 |
(6.2 × 1 + 6.13 × 0.927 + 0.48 × 0.486) × $33.4009 = $404.68
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
67220 billing questions
How does this differ from 67210?
This code is for laser treatment of a choroidal lesion. Use 67210 when the treated lesion is in the retina.
How does this differ from 67218?
Both concern a localized choroidal lesion, but 67218 describes treatment with a radioactive plaque. This code is for photocoagulation.
Does one or more treatment sessions change the code?
The code covers one or more sessions. Document the lesion and the photocoagulation performed; do not select a retinal-lesion code just because treatment required multiple sessions.
What postoperative care is included?
The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for treatment of both eyes?
Yes. CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,44167208,,Treatment of retinal lesion,A,,7.46,10.06,,6.67,,0.59,18.11,14.72,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44267210,,Treatment of retinal lesion,A,,6.20,8.80,,6.13,,0.49,15.49,12.82,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44367218,,Treatment of retinal lesion,A,,19.85,13.15,NA,13.15,,1.58,34.58,34.58,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44467220,,Treatment of choroid lesion,A,,6.20,9.25,,6.13,,0.48,15.93,12.81,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44567221,,Ocular photodynamic ther,R,,3.36,4.89,,1.42,,0.26,8.51,5.04,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44667225,,Eye photodynamic ther add-on,A,,0.46,0.37,,0.16,,0.04,0.87,0.66,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,44767227,,Dstrj extensive retinopathy,A,,3.41,5.21,,2.77,,0.26,8.88,6.44,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915